Boundary-Spanning Care: Reducing Psychiatric Rehospitalization and Self-Injury in a Jail Population.

Abstract

Individuals with serious mental illness detained in jail may require frequent psychiatric hospitalization due to the destabilizing nature of the jail environment. This study examined the impact of a pilot treatment program involving continuity of patient care across jail and hospital settings aimed at reducing hospitalizations and negative health outcomes for a population of high-risk, incarcerated individuals with mental illness. This study examined rate ratios of psychiatric hospitalizations, injuries, and suicide watches, comparing 15 patients in the treatment program to themselves pretreatment and to a control group of 15 frequently rehospitalized patients. Patients in treatment experienced significant decreases in overall hospitalizations ( p < .001), 15-day rehospitalizations ( p < .002), and suicide watches in jail ( p < .02), compared to themselves pretreatment. A boundary-spanning treatment program lowered hospitalization rates and need for suicide watch for a small, yet clinically complicated and challenging group of patients.